Nondrug treatments for psychogenic nonepileptic seizures: What's the evidence?

American Journal of Clinical Hypnosis,  Jan 2008  by Wickramasekera, Ian II

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Brooks, J.L., Goodfellow, L., Bodde, N.M., Aldenkamp, A. & Baker, G. A. (2007). Nondrug treatments for psychogenic nonepileptic seizures: What's the evidence? Epilepsy and Behavior, 55(4), 426-432. The authors of this article wished to provide a review of the existing clinical research literature into psychological and other non-pharmacological methods of reducing the symptoms and suffering caused by psychogenic nonepileptic pseudoseizures.

Many readers may well be aware of the pioneering work of Elmer Green and his colleagues using biofeedback and hypnotic methods with these patients many years ago at the Menninger Clinic. The authors utilized the standards of the Cochrane Review system in selecting among the over 600 studies they identified for inclusion in their review. Only three of the 600 plus studies were deemed worthy of inclusion using the Cochrane criteria. Two of these studies utilized hypnosis as their main intervention to teach patients how to reduce the frequency and duration of the patients' seizures. The third study utilized a paradoxical type of intervention that might be argued to have had some hypnotic elements to it by practitioners of the Ericksonian hypnosis traditions. All 3 studies reported being able to use a psychological based intervention to reduce the seizure frequency of patients with psychogenic nonepileptic pseudoseizures. However, the authors also reviewed the methodological shortcomings of these 3 studies and also discussed the general lack of the type of evidence one might expect them to have found given that most experienced clinicians and researchers of biofeedback and hypnosis have probably previously heard of this potential application of mind/body medicine before. The authors, therfore, call for more research into this area to be enacted given the potential benefits that wide usage of non-pharmacological methods to control pseudoseizures might bring to the quality and functioning levels of many patients lives. Address for reprints: J. L. Brooks, Department of Neuropsychology, Walton Centre for Neurology and Neurosurgery, Lower Lane, Fazakerley, Liverpool L9 7Lf, UK.

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